Radiation therapy versus chemotherapy as initial treatment for localized nasal natural killer (NK)/T-cell lymphoma: a single institute survey in Taiwan

• Published in: Annals of oncology Vol. 15; no. 4; pp. 618 - 625
• Main Authors: You, J.-Y., Chi, K.-H., Yang, M.-H., Chen, C.-C., Ho, C.-H., Chau, W.-K., Hsu, H.-C., Gau, J.-P., Tzeng, C.-H., Liu, J.-H., Chen, P.-M., Chiou, T.-J.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-04-2004
• Subjects: Adult; Aged; Antineoplastic agents; Biological and medical sciences; chemotherapy; combined modality; Combined Modality Therapy; Female; Humans; intent to treat; International Prognostic Index (IPI); Killer Cells, Natural - pathology; Lymphoma, T-Cell - drug therapy; Lymphoma, T-Cell - radiotherapy; Lymphoma, T-Cell - therapy; Male; Medical sciences; Middle Aged; nasal NK/T-cell lymphoma; Nose Neoplasms - drug therapy; Nose Neoplasms - radiotherapy; Nose Neoplasms - therapy; Pharmacology. Drug treatments; Prognosis; radiotherapy; Retrospective Studies; Survival Analysis; Taiwan; Treatment Outcome; Tumors; Asia; Taiwan; Antineoplastic agent; Malignant hemopathy; Radiotherapy; combined modality; Lymphoma; nasal NK/T-cell lymphoma; Natural killer cell; intent to treat; Chemotherapy; Survey; Treatment; Lymphoproliferative syndrome; Nose; T-Lymphocyte; International Prognostic Index (IPI); Killer cell; Comparative study; Localized
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdh143

Background: To clarify the role of intention to treat for patients with localized nasal natural killer (NK)/T-cell lymphoma, and to determine the prognostic factors for these patients. Patients and methods: We conducted a retrospective review of 46 patients with localized nasal NK/T-cell lymphomas treated at a single institute between January 1988 and July 2002. Results: The type of intended treatment was a significant factor for overall survival (OS) (5-year OS: RT versus CT = 83.3% versus 28.6%, P = 0.0269) or failure-free survival (FFS) (5-year FFS: RT versus CT = 83.3% versus 27.1%, P = 0.0247). In the intended chemotherapy group, salvage with radiotherapy was superior to chemotherapy alone for OS (5-year OS: 42.2% versus 20.0%, P = 0.0252) or FFS (5-year FFS: 41.0% versus 20.0%, P = 0.0352). On multivariate analysis, both N stage and serum lactate hehydrogenase level were independent factors for OS and FFS. No radiotherapy was an independent adverse factor for OS; advanced T stage and more than one extranodal involvement were independent adverse factors for FFS. Conclusions: Patients with localized nasal NK/T-cell lymphomas were better managed with radiotherapy as front-line therapy. The advantage of radiotherapy persisted even as palliative therapy after chemotherapy.